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the acord name and logo are registered marks of acord approved by named insured policy number carrier naic code fax (a/c, no): agency name: contact (a/c, no, ext): phone code: subcode: agency customer id: address: e-mail statement of no loss cancellation date date and time signed from 12:01 am on to. the insurance policy whose number is shown.
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A no-loss statement is a statement signed by you in which you represent and promise that you have not had any loss or claim (either liability or property damage) between the time your policy canceled and the time you're applying for reinstatement (your "lapse period"). Think of it like a signed testimonial that you haven't been in an auto.
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the acord name and logo are registered marks of acord approved by named insured policy number carrier naic code fax (a/c, no): agency name: contact (a/c, no, ext): phone code: subcode: agency customer id: address: e-mail statement of no loss cancellation date date and time signed from 12:01 am on to . the insurance policy whose number is shown.
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statement of no loss producer insured's name telephone number: company: approved by: code: sub code: policy #. $ amount received by: acord 37 (1/96) oc acord corporation 1996 cancellation date date and time signed applicant's signature producer witness date and timedate and time acord tm. title: alarm installers program author: penn.
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STATEMENT OF NO LOSS E-MAIL ADDRESS: AGENCY CUSTOMER ID: CODE: SUBCODE: PHONE (A/C, No, Ext): CONTACT NAME: AGENCY (A/C, No): FAX CARRIER NAIC CODE POLICY NUMBER NAMED INSURED APPROVED BY The ACORD name and logo are registered marks of ACORD. ACORD@ Created Date:
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ACORD 37 Statement of No Loss Use the clickable sections in the form below to find corresponding fields in Sagitta. When you have a question about a field on the form, click its section to access the list of Sagitta fields that populate that section of the form. ACORD 37 2008/01 Statement of No Loss
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ACORD Forms increase your efficiency. Since our first paper form was released in 1971, ACORD has provided the standard forms used by the insurance industry. ACORD Forms are now available in a variety of formats, including printable PDF, electronic fillable, and eForms. Using ACORD's standardized Forms allows for increased efficiency, accuracy.
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STATEMENT OF NO LOSS E-MAIL ADDRESS: AGENCY CUSTOMER ID: CODE: SUBCODE: PHONE (A/C, No, Ext): CONTACT NAME: AGENCY (A/C, No): FAX CARRIER NAIC CODE POLICY NUMBER NAMED INSURED APPROVED BY The ACORD name and logo are registered marks of ACORD. Title: ACORD 37 - No Loss Letter Author: mroy Created Date:
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i certify that there have been no losses, accidents or circumstances that might give rise to a claim under the insurance policy whose number is shown above, from 12:01 am on to . acord statement of no loss. author: suzanne cowan created date: 8/15/2012 4:19:52 pm title.
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The ACORD name and logo are registered marks of ACORD RECEIPT I CERTIFY THAT I AM NOT AWARE OF ANY LOSSES, ACCIDENTS OR CIRCUMSTANCES THAT MIGHT GIVE RISE TO A CLAIM UNDER THE INSURANCE POLICY WHOSE NUMBER IS SHOWN ABOVE, FROM 12:01 AM ON TO . STATEMENT OF NO LOSS. Title: Statement Of No Loss (2008/01)
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TITLE. ACORD 37 (2008/01) STATEMENT OF NO LOSS. ACORD 37, Statement of No Loss is used when: * A policy issued by your agency has been cancelled, or has lapsed, because premium for. the policy was not paid in time; * The former insured desires to pay the delinquent premium and reinstate insurance. without a lapse in coverage; and.
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TITLE. ACORD 37 (2008/01) STATEMENT OF DON LOSS. ACORD 37, Statement of No Loss belongs used when: * A policy issued by your agency had been cancelled, press has lapsed, as premium for. the basic was not gainful in frist; * The former insured hopes to pay the delinquent bonus and reinstate insurance. without a lapse in coverage; plus.
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statement of no loss 21515 hawthorne blvd suite 440 torrance, ca 90503 agency code: sub code: approved by i certify that i am not aware of any losses, accidents or circumstances that might give rise to a claim under the insurance policy whose number is shown above, from 12:01 am on to . cancellation date date and time signed applicant's.
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statement of no loss producer insured's name telephone number: company: approved by: code: sub code: policy # i certify that there have been no losses, accidents or circumstances that might give rise to a claim under the insurance policy whose number is shown above, from 12:01 am on to . receipt $ amount received by:
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Section Name Field Name Field and/or Section Description TITLE ACORD 37 (2008/01) Statement of No Loss Use ACORD 37 when: * A policy issued by your agency has been cancelled, or has lapsed, because premium for the policy was not paid in time; * The former insured desires to pay the delinquent premium and reinstate insurance without a lapse in co.
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acord 37 (1/96) c acord corporation 1996 witness date and time receipt $ amount received by: producer applicant's signature i certify that there have been no losses, accidents or circumstances that might give rise to a claim under the insurance policy whose number is shown above, from 12:01 am on to . cancellation date date and time signed policy #
